CurrentBlue Cross Blue Shield - New MexicoPolicy CPCPLAB029

Intracellular Micronutrient Analysis

This policy governs reimbursement for intracellular micronutrient panel testing for Blue Cross Blue Shield of New Mexico members and specifies that such testing is not reimbursable; providers should check plan documents for product-specific requirements.

Policy Summary

PayerBlue Cross Blue Shield - New Mexico

PolicyIntracellular Micronutrient Analysis

Policy CodePolicy CPCPLAB029

Change TypeAdministrative updateno material change

Effective DateJun 15, 2023

Next Review Date

Key ActionSubmit accurate documentation and use HIPAA-approved code sets; check plan documents for product-specific eligibility.

SourceLink

POLICY UPDATE CHANGES

Policy updated with literature review; reimbursement information unchanged.

1Not reimbursable

24Procedure codes listed

6/15/2023Plan effective

4/12/2023Approval / literature update

Coverage Determination

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Intracellular micronutrient analysis coverage

Covered when ALL of the following are met:

ALL of the following

Intracellular micronutrient panel testing (examples: SpectraCell, Cell Science Systems cell micronutrient assay, ExaTest) is not reimbursable.
BCBSNM reimbursement stance
Providers should review plan documents (Certificates of Health Care Benefits, benefit booklets, Summary Plan Descriptions, and other coverage documents) for product-specific eligibility and applicable requirements.
Documentation and eligibility responsibility
Not all lab management reimbursement criteria apply to every product; inclusion in code lists does not guarantee coverage.
Scope and coding completeness

Policy effective date and review information are maintained in the policy header; consult the policy for administrative details.

Administrative note

Billing Codes and Coding Notes

Listed codes related to intracellular micronutrient assaysCPTNot Covered

82128
82136
82180
82310
82379
82495
82525
82607
82652
82725

1–10 of 26

1/3

Coding list completeness note

Scope of listThe procedure code list is not all-encompassing; inclusion of a code does not guarantee it is a covered service or eligible for reimbursement.

Number of codes listed in policy26 codes are listed in the policy text.

Source guidanceClaims are subject to code edit protocols and may be reviewed against benefit coverage, provider contract language, medical policies, and coding software logic.

Provider Billing, Documentation, and Reimbursement Guidance

Documentation Required

Provider billing, documentation, and reimbursement stance

Providers must submit accurate documentation for services performed and bill using valid HIPAA‑approved code sets; claims are subject to code edit protocols and review against benefit coverage, provider contracts, medical policies, and coding software logic. Review applicable plan documents for product‑specific eligibility because not all requirements apply to every product; intracellular micronutrient panel testing (e.g., SpectraCell, Cell Science Systems cell micronutrient assay, ExaTest) is not reimbursable. Upon request, provide any additional documentation to support the claim.

Submit claims using valid code combinations from HIPAA‑approved code sets (CPT, HCPCS, ICD‑10, NDC, DRG, etc.).
Claims are subject to code edit protocols, claim review, and may be denied if documentation or coding is not supported.
Check Plan documents (Certificates of Health Care Benefits, benefit booklets, Summary Plan Descriptions) for product‑specific coverage determinations.
Intracellular micronutrient panel testing (examples: SpectraCell, Cell Science Systems, ExaTest) is not reimbursable.

Definitions and Examples

Intracellular micronutrient panel testing — examples

Definition examplesIntracellular micronutrient panel testing examples include SpectraCell, Cell Science Systems cell micronutrient assay, and ExaTest.

Reimbursement stanceIntracellular micronutrient panel testing is not reimbursable per this policy.

Provider action reminderProviders should verify coverage in applicable plan documents for product-specific eligibility despite this general stance.

Plan documents

Included documentsPlan documents include Certificates of Health Care Benefits, benefit booklets, Summary Plan Descriptions, and other coverage documents.

Conflict resolutionIf a conflict exists between this policy and a plan document under which a member is entitled to Covered Services, the plan document will govern.

BCBSNM discretionBCBSNM may use reasonable discretion in interpreting and applying this policy and has final discretionary authority as provided under applicable plan documents.